Christine Marie Jensen, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3315-23 Issued in WI

Practice address

13819 Hanson Blvd NW
Andover, MN 55304-7608

Phone

(763) 392-4001

Fax

(763) 862-2091

NPI assigned

Jun 16, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI, MN2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairview Lakes Health Services Hospital, Wyoming, MN, CCN 240050

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairview Clinics

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment Care Compare group
• Mile Bluff Medical Center Inc

  • Emergency Medicine Physician
  • Mauston, WI
  • NPI 1609912005

  Physician Assistant

  Medicare reassignment NPD
• Fairview Clinics

  • Clinic/Center
  • Bloomington, MN
  • NPI 1073890398
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Clinics

  • Multi-Specialty Clinic/Center
  • Maple Grove, MN
  • NPI 1841315165
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1629482849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 DIVISION ST",
            "city": "MAUSTON",
            "state": "WI",
            "postal_code": "539481931",
            "telephone_number": "608-847-6161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13819 HANSON BLVD NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553047608",
            "telephone_number": "763-392-4001",
            "fax_number": "763-862-2091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 Division St",
            "address_purpose": "LOCATION",
            "city": "Mauston",
            "state": "WI",
            "postal_code": "539481931",
            "country_code": "US",
            "telephone_number": "608-847-6161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "CHRISTINE",
        "middle_name": "MARIE",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-16",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3315-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Rose Ives, MSW, LICSW
• Susan Lynn Murdy Jaeger, M.S.
• Rose Ellen Janecke, MA, CCC-SLP
• Molli Rose Jannette, PHARM.D.
• Barbara Jo January, RN
• Carrie Latvala Jerylo, M.S., CCC-SLP
• Jacqueline Jeziorski, CFY - SLP
• Ellen Johnson, OTR/L
• Jaidyn Johnson, OTR/L
• Mikkayla Mae Johnson, OT

• Physician Assistant in Andover, MN
• Providers in Andover, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.